Hawaii’s doctor shortage jumped 20 percent over the past year as more physicians left the field amid a growing demand for medical services.

New estimates on physician supply and demand peg the current shortage at 890, and that’s expected to jump as high as 1,500 by 2020, according to the latest figures from the University of Hawaii John A. Burns School of Medicine’s Area Health Education Center.

What’s more, the state is facing a potential wave of retirements with one-third of its doctors reaching retirement age in the next five years. An estimated 18 percent of doctors are already age 65 or older.

As a result, many people can’t find a provider when they need one and often wait months to get an appointment. In many cases, particularly on the neighbor islands, residents are not getting treated promptly for serious diseases such as cancer, diabetes and heart disease or if in an accident, said Kelley Withy, primary researcher for AHEC’s Physician Workforce Assessment. The state lost almost 100 doctors last year alone, she said.

"I would already call it a crisis," Withy said. "You don’t realize how desperate it is until you can’t find the care you need."

The state currently needs 3,690 doctors but has only 2,800. The current shortage, based on 2014 numbers, is up nearly 20 percent from 742 in 2013 and 43 percent from 622 in 2012. The center didn’t collect data in 2011, and put the shortage at 658 in 2010. The center’s report will be presented to the Legislature, which opens Wednesday.

Despite the shortage, Withy said there are fewer than 40 open positions for doctors in the community.

That’s because "traditionally, physicians chose to open their own practices, and nowadays they don’t want to. They want a job," she said. "So even if we had 800 doctors who wanted to move to Hawaii, unless they wanted to open their own practice, we could not accommodate them."

Dr. Frederick Fong, a 68-year-old internal medicine specialist, has been winding down his primary care practice at the Queen’s Medical Center for the past two years and brought on a partner to take on the bulk of his patient load.

"Patients get upset when they learn that I’m winding down my practice because they want continued care, so that’s difficult," Fong said. "Physicians are looking more closely at how they can exit their practice early."

Doctors are frustrated with time-consuming governmental regulations and decreasing reimbursements, he said.

The changes in medicine, including penalties for physicians who don’t move to electronic medical records and electronic prescribing in their practices, also are adding to the burden. It also is difficult to recruit new doctors because of the state’s high cost of living and substantial overhead in private practice, Fong added.

"Doctors do feel the economic pressures placed on them," he said. "They feel government regulations place an undue burden and may compromise the time for quality care."

The greatest shortage continues to be in primary care, where the state is lacking more than 300 doctors. On the neighbor islands, especially Hawaii island, it is two to three times harder to find a physician, Withy said.

Specialties with the fastest-growing shortages include infectious disease and orthopedic surgery. There is a 65 percent shortage of specialists in infectious diseases like HIV/AIDS and antibiotic-resistant wounds, with only 13 doctors statewide, while a more than 50 percent shortage exists for general surgeons, with only 55 seeing patients.

The center is working on solutions to improve the administrative burden on physicians and to expand medical training programs, increase recruitment for local students and support loan repayment programs.

"There are 536 different ‘prior authorization’ forms that doctors need to know how to complete for patient care in Hawaii," Withy said. "It’s unnecessary busywork."

Withy is hoping lawmakers will see the importance of funding a program that will help attract more doctors to primary care and other specialties.

Last year the state was awarded more than $1 million in federal grants, or $300,000 annually for four years, to repay loans for primary care physicians and other specialists. But the program could access only $100,000 because the state didn’t provide matching funds, which is a requirement of the grant, she said.

"This program could bring in up to 50 new doctors a year if funded," Withy said. "This could save lives across the state."

The AHEC program is trying to raise matching funds at www.ahec.hawaii.edu.